Term
True or False Morphine, Methadone, & Percocet are Level 2 CDSs and cannot be renewed or called in by phone. |
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Definition
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Term
True or False Level 3 CDSs can be renewed & have an expiration peroid of 6 months. Example: Vicoden, Benzos |
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Definition
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Term
True or False Level 4 CDSs, which include Ambien, anti-tussives w/codein have the same renewal/expiration criteria as level 3. |
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Definition
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Term
True or False It is imperitive to treat depression, if present, in the pt with pain. |
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Definition
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Term
| When treating neuropathic pain with Rx such as Gabapentin or Lyrica, what is a clinical red flag for the clinician? |
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Definition
| Often very high doses are required for effect. |
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Term
True or False Pain is the most common reason pts seek tx & accounts for 50 million lost work days per annum |
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Definition
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Term
| What are some psychological effects of pain? |
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Definition
- anxiety
- depression
- sleep deprivation
- may lead to suicide
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Term
Explain the steps of the WHO pain management ladder. |
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Definition
step 1: Nonopiod with or w/o adjuvant step 2: Weak opoid with or w/o adjuvant step 3: Strong opoid with or w/o non-opoid, adjuvant.
It is permissable to skip steps. |
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Term
| What is neuropathic pain? |
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Definition
pain that is initiated or caused by a primary lesion or dysfunction of the nervous system. |
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Term
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Definition
| Pain in the distribution of a nerve. |
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Term
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Definition
| Pain in the musculoskeletal system. |
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Term
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Definition
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Term
| Who is the best assssor of pain in the pt? |
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Definition
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Term
True or False Objective s/s of pain are often inaccurate due to the subjectiveness of its nature. |
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Definition
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Term
True or False Less than 1% of pts on pain meds become addicted. |
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Definition
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Term
| Concerning oral pain meds, is it true that in the first pass metabolism (GI,portal vein,liver, circ.) that 15-64% of the drug is lost? |
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Definition
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Term
| What is the half life, duration, & peak of MSO4? |
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Definition
Half life: 2-4h Duration: 3-5h Peak: 30-60m
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Term
| What is the Half life, peak, & duration of MS Contin? |
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Definition
Half life: 2-4h Duration: 8-12h Peak: 3-8h
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Term
| How would you write an Rx for Percocet? |
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Definition
Percocet 5/325 (percocet comes in 4 strengths) Disp # 90 ninety (always write out number, dispence 1m supply only) Sig: take one tab q 4h prn pain. No refills Inquire if pt is taking other tylenol products.
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Term
| What is the difference between Oxycontin and Oxycodone? |
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Definition
Oxycontin in an extended release product. Oxycodone is an immediate release product. |
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Term
| When ordering Oxycontin, what other medications should be ordered as well? |
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Definition
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Term
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Definition
No longer perferred as a drug for acute/chronic pain. Cannot fully be reversed with Narcan. Lowers seizure threshold.
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Term
| Do transdermal patches undergo first pass effect? |
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Definition
| No. And remember to always remove any transdermal patch if the pt becomes febrile. |
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Term
| What is the half life, duration, & peak of the Fentanyl patch? |
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Definition
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Term
| What are some S/E of Fentanyl? |
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Definition
confusion, excitability apnea laryngospasm N/V Facial itching Muscle rigidity
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Term
| What are some S/E of Methadone that females may experience? |
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Definition
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Term
True or False NPs may not write for Methadone as a substitute for Heroin & may never order the liquid form. |
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Definition
| True- NPs may order pills only as a pain management tool. |
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Term
| What are some special considerations of opiates: |
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Definition
most are dose dependent route & speed of administration genetic variability of product drug-drug interactions renal/lliver impairment
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Term
| With the exception of Heroin, what do opiates cause the pupils to do? |
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Definition
| Constrict-pinpoint, stimulates 3rd cranial nerve. |
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Term
| What are some long term S/E of opiate use? |
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Definition
Edema loss of libido disrution of menses
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Term
| When ordering opiates, what are some unique considerations the practitioner should review regarding this class of drugs? |
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Definition
order stool softener with laxative does the pt need a anti emetic? instruct pt to increase fluid intake Monitor LFTs & renal function. screen for depression
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Term
True or False There is no ceiling effect on narcotics. |
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Definition
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Term
True or False It is usual to raise the dose on pts being managed for chronic pain. |
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Definition
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Term
True or False Physical tolerance to a drug does not equate to addiction. |
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Definition
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Term
True or False Pts on pain meds are less tolerant to pain, in other words, their level of tolerance to pain decreases. |
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Definition
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Term
| Is it true that some reports show that addicts are less tolerant of pain due to individual differences and drug induced neuroadaption? |
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Definition
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Term
True or False It is important to taper pts off of pain meds slowly. |
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Definition
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Term
| What are some adjuvant meds to pain meds? |
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Definition
NSAIDs anti convulsants anti depressants nerve blocks
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Term
True or False Long term preparations of pain meds & transdermals have lower street value. |
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Definition
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Term
| When ordering pain meds on the elderly, what are some special considerations? |
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Definition
decresed hepatic/renal activity slow med absorbtion changes in elimination/metabolism START LOW GO SLOW monitor closely for gait changes must use laxatives/softeners
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Term
| What is the daily max dose of Tylenol? |
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Definition
| 4 gr., it is important to review all of your pts meds to insure that combonation drugs, cold preparations do not exceed daily dose limit. |
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Term
| What are some expeced adverse effects of NSAIDs? |
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Definition
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Term
True or False Ultram should not be used in conjunction with opiates because it lowers seizure threshold. |
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Definition
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Term
| Most opiates (except Demerol) cause Bradycardia. |
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Definition
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Term
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Definition
| The pain caused by too much studying (kidding). |
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